ECMO Management for Specialists Exam
2024-2025 Current Updated
Pros of the ECMO staffing and perfusion models include expertise in ECMO
circuit flow dynamics and sophisticated troubleshooting.
Cons: A lack of patient care knowledge and grasp of ICU concepts.
ECMO Staffing Model – ECMO Specialist Model
Pros: Specialists in acute patient care and sophisticated ICU concepts
Cons: Lack of experience with ECMO advanced troubleshooting.
The Role of the ECMO Specialist
preserves the integrity of the ECMO circuit.
Titrate ECMO.
-Flows
-Sweep
-FdO2
Observe for ECMO complications.
intervenes during ECMO situations.
Assists with 'day to day' patient clinical decision-making.
The job of bedside nurse
,Assessment, Monitoring, and Documentation
Roles during ECMO bedside insertion - Bedside nurse
Do not leave the room.
Responsible for:
-IVP Medications
-Titration of drips
-Vent
-Defibrillation/ACLS
Speaking with MDS/NPs.
Delegation
Roles during ECMO bedside insertion: ECMO Specialist
Obtaining an insertion cart
Builds and primes an ECMO circuit.
Assisted MDs with cannula placement
Hands-off ECMO lines.
Notifying the bedside RN when to administer Heparin and the dosage
,initiates ECMO therapy.
Prepare and drape.
Prepare well.
OR style, not ICU style.
Cannula infections are devastating.
Full-body drape
-Wires are lengthy and can easily become polluted
-Use a femoral drape (cath lab, blue cloths, etc.).
Use a bedside table underneath the drape at the foot of the bed.
-Open all sterile kits before beginning the treatment.
Vascular Access
Encourage use of ultrasonography.
-Easier to identify the correct vessel.
-Can also confirm the cannula is in the correct spot.
Use the Pik-A and Pik-V kits for initial access.
Use a micropuncture kit for distal perfusion catheter access.
, Procedure involving two or more people
Serial Dilation.
Check for good "wire skills"
-Keep the wire straight at all times (a two-person job).
-floss the wire, moving it back and forth.
Do not kink the wire.
-May require an extremely stiff or Amplatz wire.
Adequate dilation
-move and rotate freely.
-Multiple passes
Reduce the chance for bleeding.
- Enlarge the skin incision as you go (to avoid excessive dissection).
Placement of cannula
Should be easy if properly dilated.
2024-2025 Current Updated
Pros of the ECMO staffing and perfusion models include expertise in ECMO
circuit flow dynamics and sophisticated troubleshooting.
Cons: A lack of patient care knowledge and grasp of ICU concepts.
ECMO Staffing Model – ECMO Specialist Model
Pros: Specialists in acute patient care and sophisticated ICU concepts
Cons: Lack of experience with ECMO advanced troubleshooting.
The Role of the ECMO Specialist
preserves the integrity of the ECMO circuit.
Titrate ECMO.
-Flows
-Sweep
-FdO2
Observe for ECMO complications.
intervenes during ECMO situations.
Assists with 'day to day' patient clinical decision-making.
The job of bedside nurse
,Assessment, Monitoring, and Documentation
Roles during ECMO bedside insertion - Bedside nurse
Do not leave the room.
Responsible for:
-IVP Medications
-Titration of drips
-Vent
-Defibrillation/ACLS
Speaking with MDS/NPs.
Delegation
Roles during ECMO bedside insertion: ECMO Specialist
Obtaining an insertion cart
Builds and primes an ECMO circuit.
Assisted MDs with cannula placement
Hands-off ECMO lines.
Notifying the bedside RN when to administer Heparin and the dosage
,initiates ECMO therapy.
Prepare and drape.
Prepare well.
OR style, not ICU style.
Cannula infections are devastating.
Full-body drape
-Wires are lengthy and can easily become polluted
-Use a femoral drape (cath lab, blue cloths, etc.).
Use a bedside table underneath the drape at the foot of the bed.
-Open all sterile kits before beginning the treatment.
Vascular Access
Encourage use of ultrasonography.
-Easier to identify the correct vessel.
-Can also confirm the cannula is in the correct spot.
Use the Pik-A and Pik-V kits for initial access.
Use a micropuncture kit for distal perfusion catheter access.
, Procedure involving two or more people
Serial Dilation.
Check for good "wire skills"
-Keep the wire straight at all times (a two-person job).
-floss the wire, moving it back and forth.
Do not kink the wire.
-May require an extremely stiff or Amplatz wire.
Adequate dilation
-move and rotate freely.
-Multiple passes
Reduce the chance for bleeding.
- Enlarge the skin incision as you go (to avoid excessive dissection).
Placement of cannula
Should be easy if properly dilated.
